blood administration checklist

1. Administration of Blood
Name:
Skill:
Date:
Steps Completed Comments
Yes No
1. Verifies the doctors provider’s order and documentation of informed
consent.
2. Consider cultural and religious influences and educational level when
administering blood and performing teaching with patients receiving
blood and blood products.
3. Utilize principles of body substance isolation,explain procedure to
patient, and educate patient about
Transfusion reaction symptoms to report to nurse.
4. Type and Screen is required for any red blood cell, whole blood product,
platelet, or plasma administration.
5. Draw and send this sample to blood bank in accordance with policy.
(Cryoprecipitate does not require Type and Screen.)
6. Establishes IV at KO rate or per physician’s order.
a. Prime Y tubing with normal saline solution.
b. Follow procedure for starting large bore IV, greater than 20 gauges for
adults.
6. Assess the patient for a history of transfusions and
Transfusion reaction.
7. Obtain blood or blood component from the blood bank by using
computerized physician order entry (CPOE).
8. Perform verification process.Two licensed staff members (one the
transfusionist and one a registered nurse, perfusionist, ECMO specialist,
EMT-Paramedic, PA, APRN, LPN or physician)verify audibly and view
concurrently the following:
a. Blood product with physician’s written order.
b. Patient identity by any combination of any two of the following: Patient
name, Date of birth, medical record number, last four digits of Social
Security
number, government issued photograph identification
c. Patient name and medical record number on the identification
wristband, the blood transfusion administration record (TAR) and the
compatibility label on the blood product.
c. Verifying that the unit number, donor ABO/Rh, Patient ABO/Rh,
expiration date and compatibility label are identical for the blood bag,
compatibility label and TAR.
d. The TAR remains with the patient throughout transfusion.Both staff
members sign the chart copy of the TAR and place in patient chart if
HED not available.

2. 9. Obtain vital signs:
a. Pre-transfusion vital signs are required, including a temperature. Vital signs
must be taken no more than 15 minutes prior to beginning transfusion.
b. The nurse remains with the patient for the first 15 minutes of the transfusion,
monitoring the patient closely for signs/symptoms of transfusion reaction.
c. Vitalsigns are taken 15 minutes after thetransfusionis initiated, hourly during
infusion, and upon completionofeach unit.
Exception: In critical situation, take vital signs no more than 15min prior start of
transfusion and at completion of unit.
10. Premedication to be kept ready for patient if ordered.
 Obtain vital signs 15 minutes after BT start
 Obtain vital signs 30 minutes after BT continue
 Obtain thevital sign 1 hours after BT continues
 Obtain thevital signs every 30minutes to check
 Obtain thevital sign 2 hourly
 Obtain thevital sign 3 hourly
 Obtain thevital sign 4 hourly
 Obtain thevital sign at the end of the procedure with vital parameter recorded
11. Attach blood to tubing. Spike theblood bag before hanging it up onto the pole.
Do not piggyback blood.
12. Upon completion of administration of blood, flush tubing with normal saline
unless otherwise ordered.
13. Change blood tubing after every 2 units or every 4hours.
14. See blood transfusion policy for usual lengths of transfusion. (for whole blood 2-
4hours, must be infused within 4 hours of leaving Blood Bank)
15. If no transfusion reaction noted, disposeof blood bag and tubing in biohazard
container.
16. Complete documentation in HED on blood transfusion tab.
17. Document patient/family teaching in HED.
18. See policy for blood transfusion reaction signs/symptoms and for steps to take
if transfusion reaction occurs.
Self-assessment Evaluation/validation
methods
Levels Type of
validation
Comments
Experienced Verbal Beginner Orientation
Need practice Demonstration/observation Intermediate Annual
Never done Practical exercise Expert Other
Not applicable (based Interactive class
on scope of practice)
Employee signature Observer signature
References:Blood Product Administration Policy CL 30-07.06 12/2008.